Evaluación continua, clase inversa y cooperación activa en Matemáticas para ingenieros

La Universitat Politècnica de Valencia (UPV) facilita la creación de equipos de innovación y calidad educativa (EICE). Uno de dichos equipos es GRIM4E (GRoup of Innnovative Methodologies and Assessment For Engineering education) que comenzó a realizar innovaciones metodológicas al adaptar las asignaturas de matemáticas a los grados surgidos dentro del proceso de Bolonia. Algunas de dichas innovaciones ya habían sido iniciadas con anterioridad como una evaluación continua de todas las actividades de aprendizaje desarrolladas durante el curso, con más de 30 actos de evaluación en la actualidad en las asignaturas anuales y 10 en las semestrales. Otras fueron pioneras como el empleo sistemático de la clase inversa en las prácticas informáticas de las asignaturas involucradas. Una innovación reciente destacada en nuestro ámbito ha sido el fomento de una actitud activa y colaborativa de los alumnos en la preparación de los actos de evaluación más relevantes.En este trabajo presentamos estas líneas desarrolladas por GRIM4E e incluimos resultados de encuestas anónimas realizadas para recabar la percepción de los alumnos sobre la metodología mixta empleada

Cut-offs and response criteria for the Hospital Universitario la Princesa Index (HUPI) and their comparison to widely-used indices of disease activity in rheumatoid arthritis

Objective To estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI) in patients with chronic polyarthritis. Methods Two cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal PEARL] study) and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide EMECAR]) including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC) analysis. The areas under ROC (AUC) were compared to those of validated indexes (SDAI, CDAI, DAS28). ROC analysis was also applied to establish minimal and relevant clinical improvement for HUPI. Results The best cut-off points for HUPI are 2, 5 and 9, classifying RA activity as remission if =2, low disease activity if >2 and =5), moderate if >5 and <9 and high if =9. HUPI''s AUC to discriminate between low-moderate activity was 0.909 and between moderate-high activity 0.887. DAS28''s AUCs were 0.887 and 0.846, respectively; both indices had higher accuracy than SDAI (AUCs: 0.832 and 0.756) and CDAI (AUCs: 0.789 and 0.728). HUPI discriminates remission better than DAS28-ESR in early arthritis, but similarly to SDAI. The HUPI cut-off for minimal clinical improvement was established at 2 and for relevant clinical improvement at 4. Response criteria were established based on these cut-off values. Conclusions The cut-offs proposed for HUPI perform adequately in patients with either early or long term arthritis

Dietary α‐Linolenic Acid, Marine ω‐3 Fatty Acids, and Mortality in a Population With High Fish Consumption: Findings From the PREvención con DIeta MEDiterránea (PREDIMED) Study

Background: Epidemiological evidence suggests a cardioprotective role of α‐linolenic acid (ALA), a plant‐derived ω‐3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω‐3 fatty acids (long‐chain n‐3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all‐cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long‐chain n‐3 polyunsaturated fatty acids (≥500 mg/day). Methods and Results: We longitudinally evaluated 7202 participants in the PREvención con DIeta MEDiterránea (PREDIMED) trial. Multivariable‐adjusted Cox regression models were fitted to estimate hazard ratios. ALA intake correlated to walnut consumption (r=0.94). During a 5.9‐y follow‐up, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios for meeting ALA recommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56–0.92) for all‐cause mortality and 0.95 (95% CI 0.58–1.57) for fatal cardiovascular disease. The hazard ratios for meeting the recommendation for long‐chain n‐3 polyunsaturated fatty acids (n=5452, 75.7%) were 0.84 (95% CI 0.67–1.05) for all‐cause mortality, 0.61 (95% CI 0.39–0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29–0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22–1.01) for sudden cardiac death. The highest reduction in all‐cause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [95% CI 0.45–0.87]). Conclusions: In participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to all‐cause mortality, whereas protection from cardiac mortality is limited to fish‐derived long‐chain n‐3 polyunsaturated fatty acids. Clinical Trial Registration URL: http://www.Controlled-trials.com/. Unique identifier: ISRCTN35739639

The Mesolithic-Neolithic transition in southern Iberia

New data and a review of historiographic information from Neolithic sites of the Malaga and Algarve coasts (southern Iberian Peninsula) and from the Maghreb (North Africa) reveal the existence of a Neolithic settlement at least from 7.5 cal ka BP. The agricultural and pastoralist food producing economy of that population rapidly replaced the coastal economies of the Mesolithic populations. The timing of this population and economic turnover coincided with major changes in the continental and marine ecosystems, including upwelling intensity, sea-level changes and increased aridity in the Sahara and along the Iberian coast. These changes likely impacted the subsistence strategies of the Mesolithic populations along the Iberian seascapes and resulted in abandonments manifested as sedimentary hiatuses in some areas during the Mesolithic-Neolithic transition. The rapid expansion and area of dispersal of the early Neolithic traits suggest the use of marine technology. Different evidences for a Maghrebian origin for the first colonists have been summarized. The recognition of an early North-African Neolithic influence in Southern Iberia and the Maghreb is vital for understanding the appearance and development of the Neolithic in Western Europe. Our review suggests links between climate change, resource allocation, and population turnover. (C) 2011 University of Washington. Published by Elsevier Inc. All rights reserved.Fundacao para a Ciencia e a Tecnologia (Portugal); European Science Foundation [PTDC/HAH/64548/2006]; European Union; Fundacao para a Ciencia e Tecnologia; Ministerio de Ciencia e Innovacion, Spain [HAR 2008-1920, CGL2009-07603, CTM2009-07715, CSD2006-00041, HAR2008-06477-C03-03/HIST]; European Research Council [2008-AdG 230561]; MARM [200800050084447]; Project RNM [05212]; Junta de Andalucia, Spain [0179]; FCT [SFRH/BPD/26525/2006]; CSIC "JAE-Doc"info:eu-repo/semantics/publishedVersio

Differential clinical characteristics and prognosis of intraventricular conduction defects in patients with chronic heart failure

Intraventricular conduction defects (IVCDs) can impair prognosis of heart failure (HF), but their specific impact is not well established. This study aimed to analyse the clinical profile and outcomes of HF patients with LBBB, right bundle branch block (RBBB), left anterior fascicular block (LAFB), and no IVCDs. Clinical variables and outcomes after a median follow-up of 21 months were analysed in 1762 patients with chronic HF and LBBB (n = 532), RBBB (n = 134), LAFB (n = 154), and no IVCDs (n = 942). LBBB was associated with more marked LV dilation, depressed LVEF, and mitral valve regurgitation. Patients with RBBB presented overt signs of congestive HF and depressed right ventricular motion. The LAFB group presented intermediate clinical characteristics, and patients with no IVCDs were more often women with less enlarged left ventricles and less depressed LVEF. Death occurred in 332 patients (interannual mortality = 10.8%): cardiovascular in 257, extravascular in 61, and of unknown origin in 14 patients. Cardiac death occurred in 230 (pump failure in 171 and sudden death in 59). An adjusted Cox model showed higher risk of cardiac death and pump failure death in the LBBB and RBBB than in the LAFB and the no IVCD groups. LBBB and RBBB are associated with different clinical profiles and both are independent predictors of increased risk of cardiac death in patients with HF. A more favourable prognosis was observed in patients with LAFB and in those free of IVCDs. Further research in HF patients with RBBB is warranted

Insuficiencia cardíaca crónica

Se hizo una revisión acerca de la insuficiencia cardíaca, síndrome cuya prevalencia es mayor cada día; sus causas fundamentales siguen siendo la cardiopatía isquémica y la hipertensión arterial; el predominio sistólico o diastólico de la disfunción puede tener implicaciones terapéuticas. Se ha comprobado que el ecocardiograma ha logrado la detección precoz de la disfunción, con lo cual se ha podido prevenir mediante inhibidores de la enzima conversora de angiotensina el paso a fases más avanzadas de la enfermedad y que la aprobación del uso de betabloqueadores en estos pacientes constituye una verdadera revolución en el campo de la terapia cardiovascular. Viejos fármacos como la digoxina, la espironolactona y la amiodarona han recuperado sus lugares en el tratamiento de individuos seleccionados. Los anticálcicos demuestran no ser beneficiosos y los antagonistas de los receptores de la angiotensina II se muestran promisorios. Se hizo una actualización del tratamiento en relación con la medicina basada en la evidenciaA review on heart failure, a syndrome whose prevalence increases every day, is made. Its main causes are still ischemic heart disease and arterial hypertension. The systolic or diastolic predominance of dysfunction may have therapeutic implications. It has been demonstrated that the echocardiogram has made possible the early detection of dysfunction, wich has allowed to prevent the passage to more advanced stages of the disease by administering angiotensin-converting enzyme inhibitors. The approval of the use of beta blockers in these patients is a real revolution in the field of cardiovascular therapy. Old drugs like digoxin, spironolactone and amiodarone have recovered their places in the treatment of selected individuals. The calcium antagonists have proved not to be beneficial, whereas the antagonists of angiotensin II receptors seem to be promissory. The treatment was updated in connection with evidence-based medicin